📖 What is percutaneous metastasis ablation?
Metastases are secondary tumours resulting from the spread of a primary cancer (colon, breast, lung, kidney…) to another organ. They are the most common form of advanced-stage cancer. Percutaneous ablation of metastases by radiofrequency, microwave or cryoablation can treat liver, lung, bone and soft-tissue metastases, without surgery, under CT or ultrasound guidance.
These techniques are particularly suited to patients with a limited number of metastases (oligometastatic disease, ≤ 5 lesions) with an insufficient response to chemotherapy. They are performed as an outpatient or short hospital stay at Cochin Hospital AP-HP, after MDT discussion.
What are the expected benefits?
Percutaneous ablation of metastases may be offered alone or in addition to systemic treatments, particularly in oligometastatic disease. The expected benefits are:
- Targeted local treatment of liver, lung, bone or soft-tissue metastases
- Curative intent in some oligometastatic situations (≤ 5 lesions), or palliative intent (tumour control, pain relief, spacing out chemotherapy cycles)
- Can complement systemic treatments (chemotherapy, immunotherapy) without interrupting them for long
- Less invasive than surgery, with faster recovery
- Repeatable for new lesions or in case of local recurrence
Principles and how the procedure works
The aim is to destroy metastatic lesions located in different organs (liver, lung, bone, peritoneum, skin, soft tissue…), percutaneously, under image guidance and without surgery.
On the day of the procedure — step by step
Hospitalisation courte (1 à 3 jours)
Under general anaesthesia
Ponction percutanée guidée par l'imagerie (scanner, échographie, IRM ou techniques de fusion)
Protective measures put in place if needed for adjacent structures
Destruction of the metastases using the technique best suited to their location and the clinical context
Post-procedure monitoring
What happens afterwards?
Expected, transient effects:
- Douleur modérée possible au site de ponction ou dans la zone traitée, traitée par antalgiques
- Hospitalisation courte (1 à 3 jours)
Les complications dépendent de l'organe traité — voir nos pages dédiées (foie, poumon, os) pour le détail des fréquences par organe. De façon générale :
| Complication | Description | Fréquence |
|---|---|---|
| Haematoma at the puncture site | Usually resolves spontaneously | 2–5 % |
| Complications spécifiques à l'organe traité (pneumothorax pour le poumon, hématurie pour le rein...) | See the dedicated page for the'organe concerné | Variable |
| Local recurrence | Une nouvelle ablation reste possible | 10–20 % |
Follow-up after treatment
- Suivi radiologique et oncologique à 1 et 3 mois, puis tous les 3 à 6 mois
- In case of local recurrence or a new lesion, a further ablation is possible
What are the limits of the treatment?
- Ablation is reserved for oligometastatic situations (generally ≤ 5 lesions) — beyond that, systemic treatments remain preferred
- A local recurrence is possible (10 to 20%) — a further ablation then remains possible
- New metastases may appear elsewhere, independently of the procedure, requiring regular oncological monitoring
In all cases, systemic treatments and surgery remain possible.
What other techniques and alternatives are possible?
💊 Systemic treatments
Chemotherapy, immunotherapy, targeted therapies — the reference treatment for diffuse metastatic disease, in combination with local treatments
☢️ Radiotherapy
Stereotactic radiotherapy for lung, bone or brain metastases, as an alternative or complement to ablation
🏥 Surgery
Surgical resection of accessible metastases, particularly liver or lung, in operable patients
👁️ Active monitoring
For very small or slowly progressing lesions, active monitoring may be offered while awaiting any change
What if I decide not to have the treatment?
You remain entirely free in your decision. Your case will be discussed at a multidisciplinary team meeting, and your doctor will explain the available alternatives.
Who is this method for?
All indications are validated at an oncology multidisciplinary team meeting.
- Patients with a limited number of metastases amenable to local treatment
- Patients who are inoperable or for whom a combined approach is preferred
What to prepare before the consultation?
- Toutes vos imageries récentes (scanner, IRM, PET…)
- Bilan biologique adapté à l'organe concerné
- Courrier de synthèse de votre médecin
✅ Prise en charge : Acte pris en charge par l'Assurance Maladie. Pas de dépassement d'honoraires dans notre centre.